Online Interventions to Improve Mental Health of Pediatric, Adolescent, and Young Adult Cancer Survivors: A Systematic Review and Meta-Analysis

Objective: Over the last 10 years, online interventions to improve mental health have increased significantly. This study's primary objective was to determine the effectiveness of online interventions in improving the mental health of pediatric, adolescent, and young adult (PAYA) cancer survivors. The secondary objective was to identify the independent variables associated with online intervention efficacy for mental health improvement.Methods: On June 25–30, 2021, we searched the Medline, PsycINFO, EMBASE, and Cochrane databases for eligible English language publications that reported randomized controlled trials of online interventions aimed at improving mental health among PAYA cancer survivors. The results were analyzed using a systematic review and a three-level meta-analysis.Results: Thirteen studies met the inclusion criteria. In six (42%) studies, the intervention focused on physical activity enhancement, while ten (77%) studies used self-directed interventions. Online interventions were more efficacious, compared to control conditions, in improving sleep g = 0.35 (95% CI 0.04–0.66) and psychological well-being g = 0.32 (95% CI 0.09–0.56), but not for reducing the symptoms of depression g = 0.17 (95% CI −0.13 to 0.47), anxiety g = 0.05 (95% CI −0.15 to 0.25), and pain g = 0.13 (95% CI −0.13 to 0.39).Conclusion: Online interventions were generally effective in improving mental health in PAYA cancer survivors, although negative results were found in some critical outcomes. More high-quality evidence is needed for definite conclusions to be drawn. The study protocol was registered in PROSPERO (CRD42021266276).

Development of a questionnaire to understand the information needs of adolescent and young adult cancer survivors for life and long-term health following cancer treatment.

Disease outcomes for adolescents and young adults (AYA: ages 15 – 39 years old) with cancer have improved significantly over the past four decades to over 80%. AYA survivors are a unique population who have decades of life years following cancer treatment and are at very high risk for developing chronic medical and mental health conditions. Unfortunately, there is gap by providers in providing information regarding expectations of long-term medical, cognitive, and psychosocial issues that may arise during their lifetime. The goal of this project was to understand the educational/informational needs of this unique population. In order to understand the type of information AYAs would like to know post-treatment, such as exercise, nutrition, and more, we developed a survey addressing key topics. The process of collecting data has begun and will be collected for an additional five months. Subsequently, data will be analyzed by our team to determine key areas of interest. We will then utilize social media platforms to target AYA survivors and disseminate educational information addressing those areas of interest. The overarching hypothesize is that minimizing the health information gap and increasing knowledge about survivorship in the AYA cancer population via an accepted social media platform will lead to a more informed population of survivors that can better address their life long healthcare.

Developing a Survey for Analyzing Attitudes of Adolescent and Young Adult Cancer Survivors Towards Diet, Exercise, and Social Media

Background and Hypothesis: Due to improved multidrug treatments over the past 40 years, the 5-year survival rate for children diagnosed with cancer has increased from approximately 60% to 85%. However, these treatments also cause long-term health issues, so patients must be equipped with adequate information regarding potential future complications. Only 18% of survivors report follow-up visits to a physician to discuss reducing risks resulting from their cancer, thus, there is a huge gap in health education for this population. To address this gap, a questionnaire was developed to collect data on the critical concerns adolescent and young adult (AYA) survivors have regarding wellness. We hypothesize that this survey will allow for healthcare workers to have a greater understanding of the wellness needs of AYA cancer survivors and aid in the development of an educational program that can be delivered in a manner that is acceptable to the AYA survivor population. Project Methods: A 5-point Likert scale survey was created to gather information on topics such as diet, exercise, body image, relationships, and social media. Additional questions that gather data on background information were also asked. This survey will be distributed to subjects who have recovered from cancer and are between the ages of 18 and 39. After data has been collected, statistical tests such as Spearman’s correlation and chi-square tests for independence will be used to find correlations. Expected Results: Results from this survey will be useful in understanding the experiences of AYA cancer survivors, how they view their wellness needs, and how they prefer to receive healthcare information. Potential Impact: The data from this study will inform oncology providers as to which health concerns the AYA survivor population find most important and how best to deliver that information so survivors can receive better management of their long-term health.

Relationship between chronic exposure to ambient air pollution and mental health in Korean adult cancer survivors and the general population

Background Although a significant association between air pollution and mental health has been identified, few studies have addressed this relationship based on cancer diagnosis. This study investigated whether associations between long-term air pollution and mental health conditions differ based on whether the individual has been diagnosed with cancer. Methods Nationally representative data were used and a total of 38,101 adults were included in the analyses. We assessed mental health factors such as perceived stress, depressive symptoms, and suicidal ideation, and analyzed the associations between these factors and individuals’ annual average exposure to air pollutants, including particulate matter with an aerodynamic diameter ≤ 10 μm (PM10), nitrogen dioxide, sulfur dioxide, and carbon monoxide. Results Compared with the general population, PM10 exposure in cancer survivors predicted a higher risk of depressive symptoms (odds ratio [OR] =1.34; 95% confidence interval [CI] = 1.06–1.69) and suicidal ideation (OR = 1.29; 95% CI = 1.01–1.64). Notably, the statistically significant relationship between PM10 exposure and suicidal ideation in cancer survivors disappeared after further adjustment for depressive symptoms (p = 0.3103). This pattern was also observed in the result of propensity score-matched analysis for comparison between cancer survivors and the general population. Conclusions This study provides the first evidence that cancer survivors with depressive symptoms may be more susceptible to suicidal ideation in the context of persistent PM10 exposure.